National Health Interview Survey Releases 7 New Early Release Products

August 31, 2021

The National Health Interview Survey Early Release Program has released 7 new products that include data on health insurance, key health indicators and wirless phone use.

The new products include a report that presents estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the 2020 National Health Interview Survey.

 


Geographic Variation in Health Insurance Coverage: United States, 2019

August 6, 2021

NHSR162_Cover1NCHS releases a new report that presents state, regional, and national estimates of the percentage of persons who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

Key Findings: 

  • In 2019, among persons under age 65, 12.0% were uninsured, 64.3% had private coverage, and 25.9% had public coverage at the time of the interview.
  • Among adults aged 18–64 (working-age adults), the percent uninsured ranged from 12.4% for those living in large fringe (suburban) metropolitan counties to 17.5% for those living in nonmetropolitan counties.
  • Working-age adults living in non-Medicaid expansion states (20.8%) were about twice as likely to be uninsured compared with those living in Medicaid expansion states (10.9%). Similar patterns were observed among children
    aged 0–17 years.
  • The percentage of working-age adults who were uninsured was significantly higher than the national average (14.5%) in Florida (20.6%), Georgia (22.3%), Oklahoma (25.6%), and Texas (30.5%), and significantly lower than the national average in California (11.5%), Minnesota (6.9%), New York (7.4%), Ohio (10.8%), Pennsylvania (9.8%), and Wisconsin (7.7%).
  • The percentage of people under age 65 who were uninsured was lowest in the New England region (4.6%).


Demographic Variation in Health Insurance Coverage: United States, 2019

June 29, 2021

New NCHS report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, poverty status, education level, employment status, and marital status.

Findings:

  • In 2019, 33.0 million (10.2%) persons of all ages were uninsured at the time of interview. This includes 32.5 million (12.0%) persons under age 65.
  • Among children, 3.7 million (5.1%) were uninsured, and among working-age adults (aged 18–64), 28.8 million (14.5%) were uninsured.
  • Among persons under age 65, 64.3% were covered by private health insurance including 56.5% with employment-based coverage and 6.5% with directly purchased coverage. Moreover, 4.0% were covered by exchange-based coverage, a type of directly purchased coverage.
  • Among persons under age 65, two in five children and one in five adults were covered by public health coverage, mainly by Medicaid and the Children’s Health Insurance Program (CHIP).
  • Among adults aged 65 and over, the percentage who were covered by private health insurance (with or without Medicare), Medicare Advantage, and traditional Medicare only varied by age, income level, education level, and race and Hispanic origin.


National Health Interview Survey Early Release Updates

February 11, 2021

The Early Release Program of the National Health Interview Survey (NHIS) publishes selected health estimates from an expedited schedule.

New Interactive quarterly and biannual early release estimates provide health statistics based on data from the 2019-June 2020 NHIS for selected health topics for adults aged 18 years and over.

New report on health insurance coverage provide detailed estimates from the 2019-June 2020 NHIS.  There are also health insurance quarterly web table estimates available for April–December 2019 and January–March 2020.

Wireless Substitution: Early Release of Estimates from the National Health Interview Survey, looks at household telephone status from January through June 2020.  This includes updated estimates of the size of the wireless-only and wireless-mostly population.


Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019

September 30, 2020

Questions for Amy Cha, Health Statistician and Lead Author of “Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019.”

Q: Why did you decide to do a report on this topic?

AC: In 2019, 14.5% of adults aged 18–64 were uninsured in the United States. Individuals without health insurance experience barriers to health care such as not having a usual source of care and postponing or forgoing care due to cost, which may lead to negative health outcomes. Therefore, in this report we evaluated the characteristics of uninsured adults aged 18–64 in 2019 and the percentage among uninsured adults who identified with six reasons for being currently uninsured.


Q: Was there a specific finding in the data that surprised you from this report?

AC: We were surprised that the percentage of adults who were uninsured due to cost was higher among women and adults in fair or poor health. The percentage who were uninsured due to cost increased with age from 66.8% among those aged 18–29 to 80.9% among those 50─64.


Q: How did you obtain this data for this report?

AC: The data for this report came from the 2019 National Health Interview Survey (NHIS) Sample Adult component. NHIS is a nationally representative, household survey of the civilian noninstitutionalized U.S. population. In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users. The data is publicly available on the NHIS website (https://www.cdc.gov/nchs/nhis) with detailed data documentation.


Q: Is there any trend data for this report? If so, where can I find this data?

AC: We do not have any trend data for this report. With the NHIS redesign, questions concerning the reasons for being uninsured were asked in a different manner than in previous surveys and therefore are not comparable.


Q: What is the take home message for this report?

AC: Among uninsured adults aged 18–64, the most common reason for being currently uninsured was because they perceived that they could not afford the cost of coverage, followed by not being eligible, not wanting coverage, the process of signing up was too difficult or confusing, could not find a plan that meets their needs, and they signed up for coverage, but the plan has not started yet.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–June 2019

May 28, 2020

Questions for Robin Cohen, Health Statistician and Lead Author of “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–June 2019.”

Has the percentage of people without health insurance changed much in recent years?

RC: This most recent release from the National Health Interview Survey (NHIS) includes estimates for January through June 2019. In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users. Due to changes in weighting and design methodology, direct comparisons between estimates for 2019 and earlier years should be made with caution, as the impact of these changes has not been fully evaluated at this time. A working paper entitled, “Preliminary Evaluation of the Impact of the 2019 National Health Interview Survey Questionnaire Redesign and Weighting Adjustments on Early Release Program Estimates” discusses both these issues in greater detail.


Q: Why did NCHS redesign the NHIS?

RC: In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users. The redesign aimed to improve measurement of covered health topics, reduce respondent burden by shortening the length of the questionnaire, harmonize overlapping content with other federal surveys, establish a long-term structure of ongoing and periodic topics and incorporate advances in survey methodology and measurement.


Q: Has the NHIS ever been redesigned before?

RC: The NHIS has undergone several questionnaire redesigns since its inception in 1957. The last major questionnaire redesign occurred in 1997.


Q: How was the health insurance data strengthened by this redesign?

RC: The flow and content of the health insurance questions in the redesign are similar to those from 1997-2018. The main difference is that instead of a family respondent providing health insurance information for all family members as a proxy, health insurance is now asked directly of the sample adult and the parent or guardian of the sample child.


Q: Do we have a sense of how COVID-19 has impacted health insurance coverage in the U.S.?

RC: The estimates from this report are based on data collected from January through June 2019. This is prior to the COVID-19 pandemic. There are some estimates of health insurance coverage during the COVID-19 pandemic available from the Household Pulse Survey (https://www.cdc.gov/nchs/covid19/pulse/health-insurance-coverage.htm). The Household Pulse Survey is a 20-minute survey on how the COVID-19 pandemic may impact households across the country. However, these estimates of health insurance coverage may not be comparable with those using NHIS data. 


Q: When will NHIS have data on the impact of COVID-19 on health insurance coverage?

RC: Data collection from the 2020 NHIS is ongoing, and the early release of estimates from the 2020 NHIS has not been determined.


Q: Is the uninsured # for kids higher than previously reported?

RC: This most recent release from the National Health Interview Survey (NHIS) includes estimates for January through June 2019. In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users. Due to changes in weighting and design methodology, direct comparisons between estimates for 2019 and earlier years should be made with caution, as the impact of these changes has not been fully evaluated at this time.


Q: Anything else of note in your report that you’d like to mention?

RC: In January 2019, the National Health Interview Survey launched a redesigned questionnaire. The new design collects health insurance information from one randomly selected adult and child from each household in the survey. Estimates in this report are based on the first two quarters of 2019.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2018

May 9, 2019

Questions for Emily P. Terlizzi, M.P.H., Associate Service Fellow and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2018

Q; How did the uninsured vary by age groups and compare to last year in this report?

ET: In 2018, 9.4% of persons of all ages, 11.1% of persons under age 65, 5.2% of children, and 13.3% of adults aged 18-64 lacked health insurance at the time of interview. In 2017, 9.1% of persons of all ages, 10.7% of persons under age 65, 5.0% of children, and 12.8% of adults aged 18-64 lacked health insurance at the time of interview. However, between 2017 and 2018, none of these differences by age group were significantly different.


Q: How did the uninsured vary by regions in the United States?

ET: In 2018, 7.7% of adults aged 18-64 living in the Northeast, 11.1% of those living in the Midwest, 18.4% of those living in the South, and 11.6% of those living in the West lacked health insurance coverage at the time of interview.


Q: Has there been an increase in the percentage of persons with private coverage enrolled in high deductible health plans?

ET: In 2018, almost 45.8% of persons under age 65 with private coverage were enrolled in a high-deductible health plan (HDHP). The percentage of persons enrolled in a HDHP has increased 20.5 percentage point since 2010.


Q: What is new in this report?

ET: This report provides health insurance estimates for the United States and 17 selected states using a full year of 2018 National Health Interview Survey data. Among adults aged 18–64 the percentage who were uninsured ranged from 4.9% in Massachusetts to 25.0% in Texas.


Q: What is the take home message for this report?

ET: The take-home message from this report is found in the number of Americans who no longer lack health insurance. In 2018, 30.4 million (9.4%) persons of all ages were uninsured at the time of interview. This estimate is not significantly different from the 29.3 million (9.1%) in 2017, but there are 18.2 million fewer uninsured persons than in 2010.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2018

February 27, 2019

Questions for Emily P. Terlizzi, M.P.H., Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2018

Q: How did the uninsured vary by age groups in this report?

ET: In the first 9 months of 2018, 9.2% of persons of all ages, 10.8% of persons under age 65, 4.9% of children, and 13% of adults aged 18-64 lacked health insurance at the time of interview.


Q: How did the uninsured vary by race in this report?

ET: In the first 9 months of 2018, 26.3% of Hispanic, 14.7% of non-Hispanic black, 8.8% of non-Hispanic white, and 8.2% of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage at the time of interview.


Q: How did the uninsured vary by regions in the United States?

ET: In the first 9 months of 2018, 7.3% of adults aged 18-64 living in the Northeast, 11% of those living in the Midwest, 18.1% of those living in the South, and 11.2% of those living in the West lacked health insurance coverage at the time of interview.


Q: What is the take home message for this report?

ET: I think the take-home message from this report is found in the number of Americans who no longer lack health insurance. In the first 9 months of 2018, 29.7 million (9.2%) persons of all ages were uninsured at the time of interview. This estimate is not significantly different from 2017, but there are 18.9 million fewer uninsured persons than in 2010.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–June 2018

November 15, 2018

A new report from NCHS presents selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the 2018 National Health Interview Survey, along with comparable estimates from previous calendar years. Estimates for the first 6 months of 2018 are based on data for 39,112 persons.

Key Findings:

  • In the first 6 months of 2018, 28.5 million persons of all ages (8.8%) were uninsured at the time of interview—not significantly different from 2017, but 20.1 million fewer persons than in 2010.
  • In the first 6 months of 2018, among adults aged 18–64, 12.5% were uninsured at the time of interview, 20.0% had public coverage, and 69.2% had private health insurance coverage.
  • In the first 6 months of 2018, among children aged 0–17 years, 4.4% were uninsured, 43.4% had public coverage, and 53.6% had private health insurance coverage.
  • Among adults aged 18–64, 69.2% (137.1 million) were covered by private health insurance plans at the time of interview in the first 6 months of 2018. This includes 4% (7.9 million) covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges.
  • The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan increased, from 43.7% in 2017 to 46.0% in the first 6 months of 2018.

High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

August 9, 2018

Questions for Robin Cohen, Ph.D. and Lead Author of “High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

Q: What made you decide to put together a report about high and low deductible health plans for adults with employment-based coverage?

RC: We decided to produce an analysis focusing on high-deductible health plans (HDHPs) after observing how enrollment in HDHPs has increased over the past decade. In addition, HDHP enrollment growth has been faster among those with employment-based coverage than among those with directly-purchased coverage, so it also made sense to highlight employment-based insurance plans in this study. This report examines differences in the demographic characteristics for those with employment-based coverage by plan type.    


Q: Was there a finding in your new report that really surprised you?

RC: It was the dramatic increase in high-deductible health plan (HDHP) enrollment in recent years that really surprised us. We hadn’t expected to see such a large jump, which was most notable among those with a health savings account (HSA). The percentage of adults aged 18 to 64 enrolled in an HDHP with an HSA more than quadrupled in the past decade from 4.2% to 18.9%.


Q: What differences or similarities did you see between or among various demographic groups in this analysis?

RC: Both the differences among age groups and the lack of variance by sex in this study’s findings are notable. Among adults aged 18 to 64 with employment-based coverage, there were no differences in the type of health insurance plan by sex. Enrollment in a high-deductible health plan with a health savings account was higher among adults aged 30 to 44 than those aged 18 to 29 and 45 to 64.


Q: What is the significance of having a health savings account and not having one when you have a high-deductible health insurance plan?

RC: A health savings account (HSA) allows pretax income to be saved to help pay for the higher costs associated with a high-deductible health plan (HDHP). However, this report did not examine the association of having an HDHP — coupled with an HSA — on service use and financial burden for medical care.

 

Q: Is it a choice for Americans to have a health savings account? Can anyone have one?

 

RC: A health savings account (HSA) must be coupled with a high-deductible health plan (HDHP), but not everyone enrolled in an HDHP has an HSA. High-deductible health plans with HSAs are offered to individuals both by employers and in the direct-purchase health insurance market.

Q: What would you say is the take-home message of this report?

 

RC: I think the real take-home message in this Data Brief is the role that education and income play in health insurance coverage with these types of high-deductible health plans (HDHPs). More highly educated and affluent adults were more likely to enroll in an HDHP with a health savings account (HSA) and less likely to enroll in a traditional plan or an HDHP without an HSA — than their less educated and less affluent counterparts. The National Health Interview Survey will continue to monitor different types of private health insurance, and the survey can be used to examine further differences according to plan type.

Q: Do you have trend data on high-deductible health plans going back further than 2007?

RC: No, we don’t have earlier than 2007 trend data on high-deductible health plans (HDHPs). The National Health Interview Survey began to collect data on enrollment in HDHPs starting in 2007.